Designing and testing a computer-based screening system for transfusion-related acute lung injury.

Computer-based systems can detect underreported adverse events. We hypothesized that a system could be designed to detect potential or unreported cases of transfusion-related acute lung injury (TRALI). We developed and tested a computer screening system using retrospective computer blood gas data after transfusions during a 45-day period at a tertiary care academic hospital. The program identified cases of posttransfusion hypoxemia. Medical records of identified cases were reviewed to diagnose TRALI. During the 45-day period, 820 patients received 6,888 blood products. Seven cases of TRALI were diagnosed, whereas only 2 had been reported. The system had 99% accuracy and 26% positive predictive value for detecting potential TRALI. Computer screening finds more cases of TRALI than are reported voluntarily, and a prospective study using this system is feasible and needed to validate this method of detecting this important adverse transfusion reaction.